We present a 71-year-old Caucasian female who presented with right upper quadrant abdominal pain and flank pain. As an inpatient, she subsequently developed bilateral facial palsy. After extensive workup, she was diagnosed with neurosarcoidosis. We present an algorithmic approach to diagnosing facial palsy and specific consideration when bilateral. Bilateral facial palsy accounts for <2% of all facial palsies. Unlike unilateral facial palsy, bilateral facial palsy is often associated with significant underlying disease. This systematic approach was helpful in providing the diagnosis of neurosarcoidosis and review of the disease helped confirm the diagnosis and direct further workup.
The following core competencies are addressed in this article: Patient care, Medical knowledge.